Skip to main content

Advertisement

SpringerLink
Log in

A smoking cessation and pain management program for cancer survivors

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

Many cancer survivors continue to smoke. Further, most survivors also report high levels of persistent pain and smoke in response to pain. The investigators tested the feasibility, acceptability, and preliminary efficacy of a smoking cessation program paired with a pain management program for cancer survivors.

Methods

The investigators conducted a two-arm, wait-list randomized controlled pilot study in which they delivered a combined smoking cessation and pain management intervention.

Results

The investigators randomized 30 survivors (14 intervention and 16 wait-list control). Seventy-one percent of the survivors who received the intervention rated it as extremely useful (5 out of 5) in helping them quit smoking. Further, 86% would recommend the program to other survivors. Although we could not conduct inferential statistics, 14% of those in the intervention arm, compared to 6% in the control condition had biochemically validated cessation at 2-months post-randomization. Survivors in the intervention also reported less pain, had improvements in depressive symptoms, and better physical function than those in the control arm.

Conclusions

Our pilot data suggest the feasibility, acceptability, and preliminary efficacy of this approach. The next step is to conduct a large randomized controlled trial to fully test the efficacy of the intervention.

Implications for Cancer Survivors

A combined smoking cessation and pain program might help improve both issues simultaneously.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Gritz ER, Toll BA, Warren GW. Tobacco use in the oncology setting: advancing clinical practice and research. Cancer Epidemiol Biomark Prev. 2014;23(1):3–9. https://doi.org/10.1158/1055-9965.epi-13-0896.

    Article  Google Scholar 

  2. Gritz ER, Fingeret MC, Vidrine DJ, Lazev AB, Mehta NV, Reece GP. Successes and failures of the teachable moment: smoking cessation in cancer patients. Cancer. 2006;106(1):17–27. https://doi.org/10.1002/cncr.21598.

    Article  PubMed  Google Scholar 

  3. Westmaas JL, Newton CC, Stevens VL, Flanders WD, Gapstur SM, Jacobs EJ. Does a recent cancer diagnosis predict smoking cessation? An analysis from a large prospective US cohort. J Clin Oncol. 2015;33(15):1647–52. https://doi.org/10.1200/jco.2014.58.3088.

    Article  PubMed  Google Scholar 

  4. Parsons A, Daley A, Begh R, Aveyard P. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ. 2010;340:b5569. https://doi.org/10.1136/bmj.b5569.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Garces YI, Yang P, Parkinson J, Zhao X, Wampfler JA, Ebbert JO, et al. The relationship between cigarette smoking and quality of life after lung cancer diagnosis. Chest. 2004;126(6):1733–41. https://doi.org/10.1378/chest.126.6.1733.

    Article  PubMed  Google Scholar 

  6. Warren GW, Sobus S, Gritz ER. The biological and clinical effects of smoking by patients with cancer and strategies to implement evidence-based tobacco cessation support. Lancet Oncol. 2014;15(12):e568–80. https://doi.org/10.1016/s1470-2045(14)70266-9.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Florou AN, Gkiozos IC, Tsagouli SK, Souliotis KN, Syrigos KN. Clinical significance of smoking cessation in subjects with cancer: a 30-year review. Respir Care. 2014;59(12):1924–36. https://doi.org/10.4187/respcare.02559.

    Article  PubMed  Google Scholar 

  8. Ostroff JS, Burkhalter JE, Cinciripini PM, Li Y, Shiyko MP, Lam CY, et al. Randomized trial of a presurgical scheduled reduced smoking intervention for patients newly diagnosed with cancer. Health Psychol. 2014;33(7):737–47. https://doi.org/10.1037/a0033186.

    Article  PubMed  Google Scholar 

  9. Tasmuth T, von Smitten K, Hietanen P, Kataja M, Kalso E. Pain and other symptoms after different treatment modalities of breast cancer. Ann Oncol. 1995;6(5):453–9.

    Article  CAS  Google Scholar 

  10. Rietman JS, Dijkstra PU, Debreczeni R, Geertzen JH, Robinson DP, De Vries J. Impairments, disabilities and health related quality of life after treatment for breast cancer: a follow-up study 2.7 years after surgery. Disabil Rehabil. 2004;26(2):78–84. https://doi.org/10.1080/09638280310001629642.

    Article  PubMed  Google Scholar 

  11. Hack TF, Cohen L, Katz J, Robson LS, Goss P. Physical and psychological morbidity after axillary lymph node dissection for breast cancer. J Clin Oncol. 1999;17(1):143–9. https://doi.org/10.1200/jco.1999.17.1.143.

    Article  CAS  PubMed  Google Scholar 

  12. Goudas LC, Bloch R, Gialeli-Goudas M, Lau J, Carr DB. The epidemiology of cancer pain. Cancer Investig. 2005;23(2):182–90.

    Article  Google Scholar 

  13. van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007;18(9):1437–49. https://doi.org/10.1093/annonc/mdm056.

    Article  PubMed  Google Scholar 

  14. Barbera L, Molloy S, Earle CC. Frequency of non-cancer-related pain in patients with cancer. J Clin Oncol. 2013;31(22):2837. https://doi.org/10.1200/jco.2013.49.8311.

    Article  PubMed  Google Scholar 

  15. Syrjala KL, Jensen MP, Mendoza ME, Yi JC, Fisher HM, Keefe FJ. Psychological and behavioral approaches to cancer pain management. J Clin Oncol. 2014;32(16):1703–11. https://doi.org/10.1200/jco.2013.54.4825.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ditre JW, Brandon TH, Zale EL, Meagher MM. Pain, nicotine, and smoking: research findings and mechanistic considerations. Psychol Bull. 2011;137(6):1065–93. https://doi.org/10.1037/a0025544.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hooten WM, Vickers KS, Shi Y, Ebnet KL, Townsend CO, Patten CA, et al. Smoking cessation and chronic pain: patient and pain medicine physician attitudes. Pain Pract. 2011;11(6):552–63. https://doi.org/10.1111/j.1533-2500.2011.00462.x.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Nakajima M, al’Absi M. Enhanced pain perception prior to smoking cessation is associated with early relapse. Biol Psychol. 2011;88(1):141–6. https://doi.org/10.1016/j.biopsycho.2011.07.006.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Waldie KE, McGee R, Reeder AI, Poulton R. Associations between frequent headaches, persistent smoking, and attempts to quit. Headache. 2008;48(4):545–52. https://doi.org/10.1111/j.1526-4610.2007.01037.x.

    Article  PubMed  Google Scholar 

  20. Patterson AL, Gritzner S, Resnick MP, Dobscha SK, Turk DC, Morasco BJ. Smoking cigarettes as a coping strategy for chronic pain is associated with greater pain intensity and poorer pain-related function. J Pain. 2012;13(3):285–92. https://doi.org/10.1016/j.jpain.2011.11.008.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Ditre JW, Heckman BW, Zale EL, Kosiba JD, Maisto SA. Acute analgesic effects of nicotine and tobacco in humans: a meta-analysis. Pain. 2016;157(7):1373–81. https://doi.org/10.1097/j.pain.0000000000000572.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Daniel M, Keefe FJ, Lyna P, Peterson B, Garst J, Kelley M, et al. Persistent smoking after a diagnosis of lung cancer is associated with higher reported pain levels. J Pain. 2009;10(3):323–8. https://doi.org/10.1016/j.jpain.2008.10.006.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Schnoll RA, Zhang B, Rue M, Krook JE, Spears WT, Marcus AC, et al. Brief physician-initiated quit-smoking strategies for clinical oncology settings: a trial coordinated by the Eastern Cooperative Oncology Group. J Clin Oncol. 2003;21(2):355–65. https://doi.org/10.1200/jco.2003.04.122.

    Article  PubMed  Google Scholar 

  24. Schnoll RA, Rothman RL, Wielt DB, Lerman C, Pedri H, Wang H, et al. A randomized pilot study of cognitive-behavioral therapy versus basic health education for smoking cessation among cancer patients. Ann Behav Med. 2005;30(1):1–11. https://doi.org/10.1207/s15324796abm3001_1.

    Article  PubMed  Google Scholar 

  25. Schnoll RA, Martinez E, Tatum KL, Weber DM, Kuzla N, Glass M, et al. A bupropion smoking cessation clinical trial for cancer patients. Cancer Causes Control. 2010;21(6):811–20. https://doi.org/10.1007/s10552-010-9507-8.

    Article  PubMed  Google Scholar 

  26. Nayan S, Gupta MK, Sommer DD. Evaluating smoking cessation interventions and cessation rates in cancer patients: a systematic review and meta-analysis. ISRN Oncol. 2011;2011:849023. https://doi.org/10.5402/2011/849023.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Park ER, Ostroff JS, Perez GK, Hyland KA, Rigotti NA, Borderud S, et al. Integrating tobacco treatment into cancer care: study protocol for a randomized controlled comparative effectiveness trial. Contemp Clin Trials. 2016;50:54–65. https://doi.org/10.1016/j.cct.2016.07.016.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire. Br J Addict. 1991;86(9):1119–27. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x.

    Article  CAS  PubMed  Google Scholar 

  29. Cleeland CS, Ryan KM. Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap. 1994;23(2):129–38.

    CAS  PubMed  Google Scholar 

  30. Turk DC, Dworkin RH, Allen RR, Bellamy N, Brandenburg N, Carr DB, et al. Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain. 2003;106(3):337–45.

    Article  Google Scholar 

  31. Anderson KO, Dowds BN, Pelletz RE, Edwards WT, Peeters-Asdourian C. Development and initial validation of a scale to measure self-efficacy beliefs in patients with chronic pain. Pain. 1995;63(1):77–84.

    Article  CAS  Google Scholar 

  32. Fava JL, Ruggiero L, Grimley DM. The development and structural confirmation of the Rhode Island stress and coping inventory. J Behav Med. 1998;21(6):601–11.

    Article  CAS  Google Scholar 

  33. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.

    Article  CAS  Google Scholar 

  34. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11(3):570–9.

    Article  CAS  Google Scholar 

  35. Somers TJ, Blumenthal JA, Guilak F, Kraus VB, Schmitt DO, Babyak MA, et al. Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study. Pain. 2012;153(6):1199–209. https://doi.org/10.1016/j.pain.2012.02.023.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Bastian LA, Fish LJ, Peterson BL, Biddle AK, Garst J, Lyna P, et al. Assessment of the impact of adjunctive proactive telephone counseling to promote smoking cessation among lung cancer patients’ social networks. Am J Health Promot. 2013;27(3):181–90. https://doi.org/10.4278/ajhp.101122-QUAN-387.

    Article  PubMed  Google Scholar 

  37. Hooten WM, Townsend CO, Hays JT, Ebnet KL, Gauvin TR, Gehin JM, et al. A cognitive behavioral smoking abstinence intervention for adults with chronic pain: a randomized controlled pilot trial. Addict Behav. 2014;39(3):593–9. https://doi.org/10.1016/j.addbeh.2013.11.010.

    Article  PubMed  Google Scholar 

  38. Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville: U.S. Department of Health and Human Services. Public Health Service; 2008.

    Google Scholar 

Download references

Funding

This study was funded by Duke Cancer Institute.

Author information

Authors and Affiliations

  1. Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA

    Kathryn I. Pollak, Laura J. Fish, Xiaomei Gao, Pauline Lyna & Tamara J. Somers

  2. Department of Population Health Sciences, Duke School of Medicine, 2424 Erwin Road, Suite 602, Durham, NC, 27705, USA

    Kathryn I. Pollak

  3. Department of Medicine, Duke School of Medicine, Durham, NC, USA

    Laura J. Fish

  4. Duke Cancer Network, Duke Cancer Institute, Durham, NC, USA

    Linda M. Sutton & Lynda Owen

  5. Department of Psychology and Neuroscience, Duke School of Medicine, Durham, NC, USA

    Linda M. Sutton

  6. Department of Psychiatry and Behavioral Sciences, Duke School of Medicine, Durham, NC, USA

    Michele L. Patel

  7. Faculty Practice in Psychiatry Erwin Square, Duke School of Medicine, 2200 W. Main Street Suite 340, Durham, NC, 27705, USA

    Tamara J. Somers

Authors
  1. Kathryn I. Pollak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laura J. Fish
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linda M. Sutton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiaomei Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pauline Lyna
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lynda Owen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michele L. Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tamara J. Somers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kathryn I. Pollak.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

This study was approved by the IRB at Duke University School of Medicine. Approval no. Pro00060925.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pollak, K.I., Fish, L.J., Sutton, L.M. et al. A smoking cessation and pain management program for cancer survivors. J Cancer Surviv 12, 821–827 (2018). https://doi.org/10.1007/s11764-018-0719-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-018-0719-3

Keywords

Search

Navigation